Summary

The Third Party Billing Specialist (full-time position) is a critical role in our corporate office providing direct support to one of our BHI communities. As a Private Pay Billing specialist, your primary responsibility will be census tracking and billing.

Duties and Responsibilities:

• Perform insurance verifications for all BHI communities in a timely manner.
• Perform initial Medicare Advantage Part B pre-authorizations for all BHI Communities.
• Communicate insurance and pre-authorization information with staff at each BHI Community.
• Enter new skilled residents into PCC for assigned communities.
• Process Medicare A & B and Medicare Advantage A& B Claims for assigned communities.
• Perform claim follow up for assigned communities.
• Post Third Party payments for assigned communities.
• Assist Third Party Billing Manger with resident concerns.
• Travel to assigned communities quarterly.
• Performs all other duties as requested by supervisor.

Qualifications:

• At minimum, a high school degree, together with successful work-related experience/training in Medicare and Insurance processing, is required.

• At minimum, must be able to acquire sufficient knowledge and learn new skills through on-the-job training and instructions to satisfactorily meet job performance requirements at the end of the introductory period. 

• The ability to communicate effectively, both verbally and in writing

• Basic computer related skills

• Experience with (or capacity to learn) basic/standard computer systems (billing programs, electronic spreadsheets, word processing) and office equipment, and other skills as required.